Kornimate/medical-research-clean huggingface dataset:
nociceptive gain processing after physical therapy in carpal tunnel syndrome

Conditions: Carpal Tunnel Syndrome

Summary: this randomized clinical trial will investigate changes in pain intensity and nociceptive gain processing after the application of either physical therapy or surgery in women with carpal tunnel syndrome (cts). the purpose of this study will be to determine changes in pain intensity, widespread pressure pain sensitivity and segmental thermal changes after the application of a physical therapy program based on desensitization maneuvers of the central nervous system or endoscopic surgery in women with cts at medium and long-term follow-up periods. we hypothesize that the physical therapy intervention targeted to desensitization of the central nervous system is more effective than surgical intervention for modulating altered nociceptive gain processing in women with cts.

there is increasing evidence suggesting that carpal tunnel syndrome (cts) represents a complex pain syndrome including both peripheral and central sensitization mechanisms. in fact, patients with unilateral cts exhibit bilateral widespread pressure hyperalgesia and bilateral pain hypersensitivity suggesting the presence of altered nociceptive gain processing. in addition, these sensitization processes seem to be independent of electro-diagnostic findings. previous studies support the use of physical therapy and surgical interventions for the management of pain and disability in these patients. however, there is no evidence related to changes in nociceptive gain process after the application of any therapeutic intervention. preliminary evidence suggests that manual therapies can modulate sensitization mechanisms. therefore, our objective is to conduct a randomized clinical trial to determine if manual therapies including desensitization maneuvers of the central nervous system are effective to decrease widespread pressure pain and thermal pain hypersensitivity in women with cts.

Eligibility criteria:
inclusion criteria: * pain and paresthesia in the median nerve distribution * increasing symptoms during the night, * positive tinel sign, * positive phalen sign, * symptoms had to have persisted for at least 6 months * deficits of sensory and motor median nerve conduction according to guidelines of the american association of electrodiagnosis, american academy of neurology, and the american physical medicine and rehabilitation academy exclusion criteria: * any sensory/motor deficit related to the ulnar or radial nerve; * older than 65 years of age; * previous surgical intervention or steroid injections; * multiple diagnoses of the upper extremity (eg, cervical radiculopathy); * history of neck, shoulder, or upper limb trauma (whiplash); * history of a systemic disease causing cts (eg, diabetes mellitus or thyroid disease); * history of other medical conditions (eg, rheumatoid arthritis, fibromyalgia); * pregnancy

Keywords: carpal tunnel syndrome pain sensitivity pain thresholds sensitization physical therapy
sleep intervention as symptom treatment for adhd

Conditions: ADHD; Sleep; Adolescents; CBT

Summary: up to 72% of adolescents with adhd portray sleep problems. the most common sleep difficulties in adolescents with adhd are initial insomnia, nocturnal awakenings, non-restorative or restless sleep. these difficulties seem to be causally related to increased adhd symptom impairment, oppositional and depressive symptomatology, and functional impairments in daily life, resulting in a vicious circle of sleep problems and impairment. thus, reducing sleep problems is an important intervention target. however, to date there is no evidence-based cognitive behavioral sleep treatment available. sleep-focused treatments need adaptation towards this developmental phase/disorder for effectiveness, as adhd and sleep problems are bi-directional. therefore, a blended treatment targeting the core deficits integrating motivational interviewing, planning skills and sleep interventions is needed. thus, the aim of this project is testing the short and 3 months follow-up effectiveness of the blended cbt sleep intervention in adolescents with adhd.


Eligibility criteria:
inclusion criteria: 1. attending secondary education and between 13-17 years old 2. prior diagnosis of adhd (any presentation) and confirmation of dsm-5 criteria of adhd in current study 3. displaying sleep problems for at least 3 nights per week for at least 3 months 1. sleep onset latency of at least 20-30 minutes 2. and/or wake after sleep onset greater than 30 min 3. and/or an average sleep time of less than 7 hours 4. and at least one poor sleep hygiene practice 5. and experienced distress as indicated by parent/guardian and/or adolescent. 4. estimated iq≥80 5. stable adhd medication use at least 4 weeks before start of treatment and no dose or medication type changes planned during active treatment exclusion criteria: 1. the following comorbidities: sleep-breathing disorder, restless leg syndrome, narcolepsy, conduct disorder, depressive disorder with suicide risk or active suicidality, autism spectrum disorder, or substance use disorder, with an exception for nicotine 2. acute crisis situation at home 3. physical problems that interfere with sleep (e.g. pain) or medical disorders and related medication that could affect sleep 4. participation in a behaviorally based sleep intervention in the 6 months prior to our study 5. currently taking pharmacological medication for sleep (including melatonin), anxiety or depression. participation will be allowed after a two-week wash-out period of the medication
sexual therapy and rehabilitation after treatment for ovarian cancer (start-oc): a pilot intervention

Conditions: Ovarian Cancer

Summary: this research study is evaluating an educational intervention for women who have experienced changes in sexual function after treatment for ovarian cancer.

the purpose of this research is to study the effectiveness of an educational intervention for women who have experienced changes in sexual function after treatment for ovarian cancer. the aim is to develop an effective intervention to help women manage these changes and restore sexual health and functioning. this study consists of attending a group educational session followed by a one-on-one telephone counseling session.

Eligibility criteria:
inclusion criteria: * women diagnosed with stage1-iv ovarian cancer * prognosis of at least one year to live (as assessed by provider) * endorsement of at least one sexual symptom (see appendix a for eligibility screening) * english speaking * signed informed consent exclusion criteria: * history of pelvic radiation * cognitive impairment which would interfere with the ability to participate in the study (as assessed by provider)
an observational study on sarilumab-exposed pregnancies

Conditions: Rheumatoid Arthritis -Exposure During Pregnancy

Summary: primary objective: to evaluate the relative risk of major structural birth defects, specifically a pattern of anomalies, in sarilumab-exposed pregnancies compared to disease-matched unexposed pregnancies. secondary objective: to evaluate the risk for sarilumab-exposure relative to the group of healthy pregnant women, and the effect of exposure on other adverse pregnancy and infants outcomes.

pregnant women enrolled in the study will participate for the duration of that pregnancy. those who deliver at least one live born infant and the infants will participate for 1 year after delivery of that infant.

Eligibility criteria:
inclusion criteria: * cohort 1: sarilumab-exposed cohort * currently pregnant, exposed to kevzara (sarilumab) for approved indication * cohort 2: disease-matched comparison cohort * currently pregnant, diagnosed with kevzara (sarilumab) approved indication * cohort 3: non-diseased comparison cohort * currently pregnant, not diagnosed with a kevzara (sarilumab) indication and unexposed to kevzara exclusion criteria: first contact the registry after prenatal diagnosis of any major structural defect or after pregnancy outcome is known (retrospective data). enrolled in this cohort study with a previous pregnancy. cohort 1: sarilumab-exposed cohort * exposed to kevzara (sarilumab) for an indication other than a currently approved indication. * exposure to another biologic during pregnancy or within 10 weeks prior to the first day of lmp. * exposed to methotrexate, cyclophosphamide, chlorambucil, or mycophenolate mofetil in pregnancy (ie, at any time after the lmp), or leflunomide within two years prior to pregnancy unless a blood level for leflunomide below 0.02 mcg/ml has been documented prior to lmp before the pregnancy. * cohort 2: disease-matched comparison cohort * exposure to any kevzara (sarilumab) during pregnancy or within 10 weeks prior to the first day of the lmp. * exposed to methotrexate, cyclophosphamide, chlorambucil, or mycophenolate mofetil in pregnancy (ie, at any time after the lmp), or leflunomide within two years prior to pregnancy unless a blood level for leflunomide below 0.02 mcg/ml has been documented prior to lmp before the pregnancy. * cohort 3: non-diseased comparison cohort * diagnosed for any serious chronic disease that is thought to adversely impact pregnancy. * exposed to a known human teratogen during pregnancy as confirmed by the otis research center the above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
automatized "semi-whole-body"-mri protocol for cancer staging

Conditions: Oncology

Summary: the aims of this study are * to evaluate the image quality and robustness of a whole-body mri protocol by using an innovative partially automatic algorithm (dot engine), that automatically optimizes protocol parameters depending on body region (e.g. thorax versus abdomen) * to compare lesion detectability between wb-mri and the gold standard positron emission tomography (pet)/ct * to compare patient comfort between pet/ct and wb-mri using a dedicated questionnaire * to compare duration of image acquisition with regards to cost-effectiveness

whole-body imaging becomes increasingly important in oncologic patients not only for primary cancer staging, but also for assessment of response to therapy. so far, pet/ct is a key method to assess cancer-related changes of metabolism in tumors, which is crucial for response evaluation and to differentiate between benign and malignant lesions. limitations of pet/ct include the assessment of sclerotic bone metastasis, which often do not show increased tracer uptake. certain organ metastasis (especially in brain and liver) are also barely detectable due to physiologically increased uptake. moreover, both ct and administration of radioactive tracer are associated with radiation exposure for patients. whole-body mri (wb-mri) including functional techniques (e.g. diffusion-weighted imaging (dwi) to evaluate cell density) enables a functional staging and therapy assessment without use of ionizing radiation. advantages to assess sclerotic bone lesions and organ metastases have been confirmed in recent literature. limitations of mri include detection of lesions in organs with high susceptibility and motion like the thorax.

Eligibility criteria:
inclusion criteria: * clinically indicated pet/ct for cancer staging or response assess-ment in patients with histopathologically confirmed solid tumors (e.g.prostate, breast, gastrointestinal, testicles) * mri can be scheduled within 1 week to pet/ct exam exclusion criteria: * general mri contraindications (devices (e.g. certain pacemakers), pregnancy, claustrophobia) * severely reduced general condition * impaired renal function
urethral stricture: a comparison between jugal or labial graft urethroplasty

Conditions: Urethral Stricture

Summary: buccal mucosa urethroplasty is a current fashion in urethral stricture management. in our university centre (hospital de clínicas de porto alegre) is a common surgical treatment choice. this paper aims to evaluate the success rate of this treatment after randomized choice between labial and jugal (inner cheek) grafts during the past two years.

free dorsal graft urethroplasty, first described by barbagli et al, has been shown better results than ventral grafts. fixed grafts on the corpora cavernosa results in a better mechanical support and vascular supply, with less chance to complications such as pseudodiverticula and sacculations either a better urethral phisiology. this study aims to evaluate the current surgical management in our centre: buccal mucosa graft urethroplasty with jugal or labial replacement, comparing their group success rate and complications between the groups in patients led to surgery from october 2016 to june 2018. prospective analysis from urethral stricture surgical hcpa patient data by dorsal buccal mucosa graft urethroplasty. the graft choice were done by a software. longer stricture with transoperative need for the two grafts use were excluded. success rate were measured with a no stricture de novo or absence of complications in a six month interval.

Eligibility criteria:
inclusion criteria: * urethral stricture diagnosis * indication for buccal mucosa graft urethroplasty * accept the informed consent term (patient or responsible) exclusion criteria: * severe urethral stricture which a two-staged procedure are required * long strictures which need a both types of buccal mucosa graft due its length. * refuse to ict for the patient ou it responsible

Keywords: urethral stricture mucosa graft jugal graft, labial graft success rate
capsaicin in digital osteoarthritis versus control

Conditions: Osteoarthritis Hand; Neuropathic Pain

Summary: the objective of this multicentric, randomized controlled double-blind clinical trial is to demonstrate the efficacy of transdermal application of capsaicin in patients with painful digital osteoarthritis with a neuropathic pain component. participants will receive either a transdermal patch of capsaicin 179 mg (8%) or the control treatment (capsaicin 0.04%). researchers will compare the intensity of pain in the fingers at day 60 in the capsaicin 8% group versus capsaicin 0.04% (control arm)

visit 0 : screening visit (d0 - 30 days): screen for eligibility visit 1 :inclusion visit (d0): randomization and blinded patch application of capsaicin 8% or 0.04% visit 2: follow-up visit 1 (d60 + 7 days): assessment +/- patch renewal. patients with finger pain still greater than 4/10 may receive an open application of a capsaicin 8% visit 3:follow-up visit 2 (d120 +/- 7 days): final assessment. for the duration of the study, the patient will record in a notebook: analgesics, anti-inflammatories, corticoids and daily hand pain vas. blood samples will be taken at v1 and v2 for subsequent measurement of pro-inflammatory cytokines (il6, il8, tnfa) and markers of cartilage degradation, in order to build up a serum library.

Eligibility criteria:
inclusion criteria: * diagnosis of digital osteoarthritis fulfilling the american college of rheumatology criteria; * presence of finger pain of ≥ 40 mm on a visual analogue scale (vas); * presence of finger pain with a neuropathic pain component (dn4 score ≥ 4/10) * inadequate response, adverse reactions, and/or contraindications to conventional analgesics and nsaids; exclusion criteria: * patient with isolated rhizarthrosis; * patient with other joint disease affecting the fingers (gout, chondrocalcinosis, ra, spondyloarthritis, psoriatic arthritis); * patient with upper extremity pain syndrome that may interfere with the assessment of finger pain; * patient with another pathology responsible for neuropathic hand pain (carpal tunnel syndrome, diabetic neuropathy, guyon's tunnel syndrome, cervicobrachial neuralgia, brachial plexitis); * patient with skin lesions on the fingers (psoriasis, wounds, chronic ulcers, eczema, shingles, dermatitis); * patient with poorly controlled high blood pressure; * patient with hypersensitivity to capsaicin; * patient who had 8% capsaicin patch use in the year prior to the study; * patient who has received intramuscular, intra-articular or intravenous corticosteroid therapy, another disease-modifying anti-rheumatic therapy (methotrexate, salazopyrine) or an intra-articular injection into the joints of the fingers within the previous 3 months; * patient wearing wrist or finger orthoses in the previous month; * patient with fibromyalgia;
post-marketing surveillance of administration of botulinum toxin type b(nerbloc)-investigation of the clinical condition in patients with change from botulinum toxin type a

Conditions: Cervical Dystonia

Summary: investigation of the clinical condition in patients with cervical dystonia by toronto western spasmodic torticollis scale (twstrs)


Eligibility criteria:
inclusion criteria: patients with cervical dystonia who was treated by botulinum toxin type a in the past. patients who was enrolled in nb01s and was evaluated by twstrs at the first injection of nerbloc.

Keywords: torticollis rimabotulinumtoxinb
effects of pregnancy and childbirth on pelvic floor morphology and sexual function in egyptian women

Conditions: Pregnancy, Childbirth and Puerperal Disorders

Summary: the purpose of this study is t o evaluate levator ani morphology following normal vaginal delivery and cesarean section (elective and emergent), using three-dimensional (3d) ultrasound, and to study the effect of mode of delivery on female sexual function.

1. transperineal pelvic floor ultrasound applied for the submitted 120 women "primiparae" (40 women after normal vaginal delivery), (40 women after urgent cesarean section), (40 women after elective cesarean section), in early postpartum period (48 to 72) hours postpartum, to evaluate levator ani morphology. 2. answering of the validated female sexual function index (f.s.f.i) three months postpartum period for same cases submitted to ultrasound.

Eligibility criteria:
inclusion criteria: * primiparae in early postpartum period (48 hours to72 hours). written consent was taken. easy communicable, reachable women for further requirements. exclusion criteria: * refused consent. 2. previous vaginal or cesarean delivery. 3. severe mental illness. 4. severe physical handicap or difficulties in communication. 5. women without postpartum active sexual life or separate from their spouse. 6. past history of sexual dysfunction.

Keywords: postpartum pelvic floor
pandora: delirium prevention after cardiac surgery using iv acetaminophen to prevent postoperative delirium in older cardiac surgical patients

Conditions: Delirium in Old Age; Delirium; Coronary Artery Disease

Summary: our objective is to find an effective prophylactic intervention by evaluating iv acetaminophen's impact in reducing the frequency of postoperative delirium, one of the most common and detrimental complications of cardiac surgery in older adults.

this project will study the impact of scheduled administration of iv acetaminophen on the incidence, duration, and severity of postoperative delirium and other important hospital outcomes. additionally, this trial will evaluate the effects of iv acetaminophen on longer-term postoperative cognitive dysfunction and functional status and develop a biorepository of perioperative samples as a future resource to probe the mechanisms of postoperative delirium. the investigators propose three specific aims by conducting a randomized, triple-blind clinical trial that enrolls 900 patients 60 years of age or older undergoing cardiac surgery. through this trial, the investigators will determine the effect of iv acetaminophen on; 1. the incidence, duration, and severity of postoperative delirium, 2. the use of opioids and other rescue analgesics in the first 48 postoperative hours, daily pain scores at rest and exertion, and length of stay in the intensive care unit and overall hospital length of stay 3. longer-term (one, six, 12 months) cognitive, physical, and self-care functional recovery after surgery.

Eligibility criteria:
inclusion criteria: 1. ≥ 60 years of age 2. patients undergoing cardiac surgery \[coronary artery bypass grafting (cabg) with or without valve, isolated valve surgery\] requiring cardiopulmonary bypass exclusion criteria: 1. pre-operative left ventricular ejection fraction (lvef) \< than 30% 2. emergent procedures 3. isolated aortic surgery 4. liver dysfunction (liver enzymes \> 3 times the baseline, all patients will have a baseline liver function test information), history and exam suggestive of jaundice 5. hypersensitivity to the study drugs 6. active (in the past year) history of alcohol abuse (≥5 drinks per day for men or ≥ 4 drinks per day for women) 7. any history of alcohol withdrawal or delirium tremens 8. delirium at baseline 9. non-english speaking 10. prisoners 11. physician refusal 12. covid-19 positive, symptomatic 13. co-enrollment with non-approved interventional trial

Keywords: acetaminophen postoperative delirium cardiac surgery
comparison of plant-based or animal-based protein on anthropocentric and metabolic parameters in obese subjects

Conditions: Obesity, Abdominal; Glycation End Products, Advanced; Inflammation; Gut Microbiota

Summary: the investigators will try to evaluate the effects of substitution of dietary animal protein by black soybean milk (400 ml x 2) per day on anthropocentric and metabolic parameters in obese subjects.

according to the survey by the ministry of health and welfare, the proportion of obese male adolescents in taiwan has been increasing year by year. obesity is associated with chronic low-grade inflammation. obese people prefer to intake foods containing higher levels of advanced glycation end products (ages). high intake of dietary ages (dages) results in abdominal obesity, and shows positive correlation with body mass index (bmi) and waist circumference. when a large amount of ages accumulates in the body, inflammation usually occurs. therefore, reducing dages intake prevents the incidence of obesity, chronic diseases and aging. black beans are high in protein. the black bean coats contain high level of anthocyanins. previous studies demonstrated the biological functions of anthocyanins on blood lipid regulation, inflammation, and also inhibition of ages formation. compared with meat (beef, pork, lamb, chicken, and seafood), the plant protein source, soy milk, under the same protein content showed significantly lower dage. in this study, the investigators will try to eveluate the effects of substitution of dietary animal protein by black soybean milk (400 ml x 2) per day on anthropocentric and metabolic parameters in obese subjects. this will be a randomized crossover interventional trial for 16 weeks: 0 to 4 weeks will be run-in period, 4 to 8 weeks and 12 to 16 weeks will be the soy milk or meat intervention period, and the between of two interventions (8 to 12 weeks) will be washout period. the body composition, blood pressure and age level will be measured. the blood, urine and feces sample will be collected for biochemical analysis and gut microbiome. the investigators expect the results could support the promotion of plant protein as part of dietary protein source to improve abnormal anthropometric and metabolic parameters in obese subjects.

Eligibility criteria:
inclusion criteria: * 20 to 64 year male or female * 27 \ = 90 cm/female \>= 80 cm * fasting blood glucose: 100-125 mg/dl exclusion criteria: * hypertension, cardiovascular disease, endocrine disease, acute and chronic liver and kidney disease, mental disease, binge or anorexia, or long-term drug use * consume probiotics, prebiotics, antibiotics or weight loss drugs regularly for the past month * try to lose weight and do resistance exercise regularly for the past month * allergic to soy products

Keywords: advanced glycation end products obesity plant protein inflammation gut microbiota